1783 E Park Ter RES19-0312 Replace 9 Windows r .t RESIDENTIAL PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH RES19-0312
,,:\ 800 SEMINOLE ROAD ISSUED: 10/17/2019
ri:35>" V ATLANTIC BEACH. FL 32233 EXPIRES: 4/14/2020
MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION.
ALL WORK MUST CONFORM TO THE CURRENT 6TH EDITION (2017) OF THE FLORIDA BUILDING
CODE, NEC, IPMC, AND CITY OF ATLANTIC BEACH CODE OF ORDINANCES .
ALL CONDITIONS OF PERMIT APPLY, PLEASE READ CAREFULLY.
NOTICE: In addition to the requirements of this permit,there may be additional restrictions applicable to this property
that may be found in the public records of this county, and there may be additional permits required from other
governmental entities such as water management districts, state agencies,or federal agencies.
JOB ADDRESS: PERMIT TYPE: DESCRIPTION: VALUE OF WORK:
1783 E PARK TER RESIDENTIAL ALTERATION REPLACE 9 WINDOWS $9454.00
RESIDENTIAL
TYPE OF REAL ESTATEBUILDING USE i
CONSTRUCTION: NUMBER: ZONING: GROUP: SUBDIVISION:
172020 0416 SELVA MARINA UNIT 08
COMPANY: I ADDRESS: CITY: STATE: ZIP:
LOWES HOME CENTERS 4948 TELSON PL ORLANDO FL 32812
INC
OWNER: ADDRESS: CITY: STATE: ZIP:
RICCI DAVID J 1783 PARK TER E ATLANTIC BEACH FL 32233
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT
IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF
COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST
INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN
ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
=`, LIST OF CONDONS
Roll off container company must be on City approved list . Container cannot be placed on City right-of-way.
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
BUILDING PERMIT 455-0000-322-1000 0 $100.00
BUILDING PLAN CHECK 455-0000-322-1001 0 $50.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.25
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL: $154.25
Issued Date: 10/17/2019 1 of 2
c 'J` RESIDENTIAL PERMIT PERMIT NUMBER
.r CITY OF ATLANTIC BEACHRES19-0312
V800 SEMINOLE ROAD1 ISSUED: 10/17/2019
j } ATLANTIC BEACH. FL 32233 EXPIRES:4/14/2020
Issued Date: 10/17/2019 2 of 2
s j
iyL� City of Atlantic Beach APPLICATION NUMBER
fWABuilding Department (To be assigned by the Building Department.)
800 Seminole Road 1R LSI 9 -
D 3 1
KlerAtlantic Beach, Florida 32233-5445 �\ t
Phone(904)247-5826 • Fax(904)247-5845
E-mail: building-dept@coab.us Date routed: ( C)/i ( /19
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Yes
Property Address: 17g3 E k ( E D ment review required /N o 2
Building
Applicant: L (f)(A_De__S kt omE_ CGA)r��.Planning &Zoning
Tree Administrator
Project: 9 W ( ( .)(J c b0 S Public Works
Public Utilities
Public Safety
Fire Services
Review fee $ Dept Signature
—
Other Agency Review or Permit Required Review or Receipt Date
of Permit Verified By _
Florida Dept. of Environmental Protection
Florida Dept. of Transportation ,(
St. Johns River Water Management District
Army Corps of Engineers -NO 'C
'C./
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First Review: I proved. ❑Denied. ❑Not applicable
(Circle one.) Comments:
(BUIL
PLANNING &ZONING Reviewed by: 141 Date: 10-15--/9
TREE ADMIN. Second Review: ❑Approved as revised. ❑Den d. ['Not applicable
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied. ❑Not applicable
Comments:
Reviewed by: Date:
Revised 05/19/2017
Buildingpp
/�� Permit Application
CI—
", i1 City of Atlantic Beach Building Department ••ALL INFORMATION.:,� 800 Seminole Road, Atlantic Beach, FL 32233 HIGHUGHTED IN GRAY
IS REQUIRED.
Phone: (904) 247-5826tEmail: Building-Dept(@caatf.iis
.rib Address: n I[3 P1f'L-tl- i CtZ E.f. fit.¢:j r Permit Number REst9 - 0 31 Z
Legal Description• 34-85 09-2S-29E SELVA MARINA UNIT 8 LOT 10 BLK 14 REu 172020-0416 LU
Valuation of Work(Replacemr'r,t Cost)$ 9,454.00 Heated/Cooled SF Non.Heated/Cooled •�)
• Class of Work: DNew `lAddition DAlteratron Repair t(Move LJDernc ;_JPooi Vindow/Door
• Use of existing/proposed structure(s): DComrnerciai Viesidential O
CI
LU
• an existing structure,is a fire sprinkler system installed': Cyes No 0 1
• Wit tree(S)be removed in association with proposed Fernee) 7. Yes must subm't.se•arate Tree Removal Permit' _.i
z
Describe in detail the type of work to be performed: C.9
1 Qf. ti. mE 1,0/t1/4./.0 i-41:4- RE'LACE 9 WINDOWS SIZE FOR SIZE o.
5 LLI 0 lei
I orda Product Apprr yal if 20471.1 ;_20472.1 ; 20472. F"
..._. _._.._.__ .. '*�'multiple products usv product arsprnvalQ�rr t� � U zs„
Property Owner inf. ation w p
Nam: . :G' -ICCI Address 1783 PARK TER E A CCa
City ATLANTIC BEACH State FL '. r a3 Phar,!. (904) 894-5551 V N
c
Mail LX Fs o F2
?)wrier or Agent(If Agent.Power of Attorney or Agency Letter Requiredi N/A L
Contractor Information u.
Name r f r n l:ar Lowes Home Centers LLC Qualifying,agent Pete Cafaro ? �, a Lt m
'id ss PO BOX 781993 t Orlando.._.. stat Th, , :� le
-- FL .. 32878..� .— ,-1 w
Office Ph-,,.(904)570-0989 �Job site coro,rt N,rnlxr_Datl.Smith.(904) 570-0989_ .s�t._� ui ww
Statecertificatron/Registr,:i,r,11 CGC1508417 E-Mail vood1O63088@gmaiI.com___ 5 cc w
N/A w _ 5
Architect Name$ Phone a; 1,A W
Engineers Name&Phone a N/A ; _ cc
Workers Compensations Insurer XWC_.5565602 OR Fx,,,,pt • F+rptratinn Data 04/01/2020
Application is hereby made to obtain a permit to do the work and installations as indicated i;artily that no work or installation has
commenced poor to the issuance of a permit and that all work will be performed to meet t' .tarcards of all the laws rcguI,ter':►;
construction in this;urisdictiort. I understand that a separate permit must be secured for ELECT-RICAL WORK,Pi.UMBING SIGNS.
WELLS,S,POOLS,I URNACFS,BOILERS,HEATERS,TANKS,and AIR CONDITIONERS,etc. NOTICE:In addition to the re n: , ���+ r`'
permit,there may be additional restrictions applicable to this property that may be found in the public records of hc � 1 Y
there may be additional permits required from other governmental entities such as water management districts,state agencies,or
federal agencies.
OWNER'S AFFIDAVIT:I certify that all the foregoing information is accurate and that all work will be done in compliance,'7.,
apa:icable laws regulating construction and zoning. OI T 2019
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPER Y. IF YOPVII hDepartment
rrt
TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATT r,RN_' BEFC1ft4Y of Atlantic Beach, F
RECO€RDING YOUR NOTICE OF COMMENCEMENT. y 44
(Slgnaturh or Owner or Agent; ISrgoah.nre of Cor:tractori -
Si -ed and sv r+to(or affirpietf)before ire this Z- 7day cf Signed'rid sworn to(or affirmed)before me this 27 day of
,; erreJ
4 s ,
:Personalty Known( ------- i Personally Known CPR 11. iii an src� a� ,� �8
( ociu ed Identification I I Produced Identification ,- �r^r`- _z',1 xP, '6.2A'r':.
me of identification. L.. Type of:denufic:rte,^..n: • ``
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